Medicine and Health Sciences Commons^™

Professional Quality Of Life And Emergency Department Nurses' Communication Patterns, Elvira Dominguez-Gomez Phd

Dissertations

The purpose of this mixed methods embedded design study was to examine relationships between compassion satisfaction, burnout, compassion fatigue/secondary trauma, and perceived levels of communication difficulty in emergency room nurses employed at a health care system. Quantitative data was collected from a purposive sample of 43 emergency room nurses using the Professional Quality of Life Scale (ProQOL), the Silencing Response Scale, and a demographic form. The study's embedded qualitative component was participants' experiences with traumatic cases in the emergency room. Qualitative data was collected via telephone interview with 10 emergency room nurses obtained from a subset of the original sample …

Fetal Heart Monitoring, Nursing Surveillance, And Cesarean Birth, María Del Carmen Colombo Phd

Dissertations

Purpose: Birth by cesarean delivery is a major public health issue with nearly one in three births delivered by cesarean section. Cesarean birth may be necessary to save mother or baby, but the rapid rise since 1996 without concomitant reduction in maternal and neonatal morbidity and mortality may indicate this mode of delivery may be over utilized. Cesarean births pose significant maternal and newborn health risks. Identification of factors that may contribute to reduction in the first cesarean birth in low-risk women who are nulliparous, term gestation, with single fetus in head down position (NTSV) is a health priority. The …

Transitioning Adolescents With Type I Diabetes To Adult Care, Kathyann Kenny Marsh Phd

Dissertations

Background: Care transitions, defined as hospital discharge or movement from one healthcare setting to another, are currently a major concern for healthcare providers and policy makers alike. These care transitions are occurring in the context of increasingly fragmented care and have been known to result in hospital readmissions, adverse events, and medication errors. The adolescents' transition between pediatric and the adult care system is not only fragmented but occurs at a time when they are most vulnerable and ill equipped for change. Objectives: The purpose of this research was to conduct a feasibility study to examine if the use of …

A Phenomenological Study Of Acceptability Of Preexposure Prophylaxis Therapy Within The Lived Experiences Of Hiv Negative Male-To-Female Transgender Young Adults, Gloria N. Nwagwu Phd

Dissertations

The male-to-female transgender (MtF-TG) are individuals assigned a male gender at birth but self identify as female. MtF-TG young adults experience discrimination, stigmatization, isolation, and homelessness as a result of gender identity and gender expression. The transgender populations are linked to high rate of new HIV infection. The use of Preexposure prophylaxis (PrEP) therapy demonstrated a decrease in HIV infection risk ranging from 42% to 73% among sexual minority individuals. The goal of this three-part study was achieved through concept analysis, data collection, and analysis. The following aims were addressed; analyze the concept of transgender, explore currently used HIV prevention …

Hospital Fall Prevention Using Interactive Patient Care Technology, Verna A. Sitzer Phd, Mn, Rn, Cns

Dissertations

The impact of patient engagement in hospital fall prevention using interactive patient care technology is not known. The purpose of this investigation was to examine the engagement of hospitalized patients in a computer-based, interactive patient care fall prevention pathway, comprised of a self-assessment of fall risk questionnaire and a fall prevention video, and hospital fall outcomes. The aims were to 1) formulate an interactive patient care technology conceptual framework to guide the study, 2) provide reliability and validity evidence for a patient self-assessment of fall risk questionnaire, and 3) explore the relationship between the fall prevention pathway engagement characteristics and …

Hypoxic Signals In The Ischemic Myocardium: Role Of Galectin-1 And Galectin-3, Satwat Hashmi

Dissertations

Myocardial infarction is the most serious manifestation of coronary artery disease and the cause of significant levels of mortality and morbidity worldwide. Galectin-1 (GAL-1) and Galectin-3 (GAL-3) are beta galactoside binding lectins with diverse functions. Hypoxia inducible factor-1 alpha (HIF-1α) is a transcription factor mediating early and late responses to myocardial ischemia. We aim to study the direct effects of ischemia on GAL-1, GAL-3 and HIF-1α in the heart. Male C57B6/J and GAL-3 knockout mice were used for our two disease models. In the Myocardial infarction (MI) model, the left anterior descending artery of the heart is permanently ligated to …

The Role Of Glutamate Signalling In Diabetic Neuropathy, Nadia Hussain

Dissertations

The majority of diabetics develop neuropathy, which can be debilitating, but the underlying pathophysiological mechanisms are poorly understood. Diabetic neuropathy progresses in a distal to proximal manner. Previous studies have shown that glutamate, the most common excitatory neurotransmitter, plays a role in the pathogenesis of neuropathy. The reason why the role of glutamate in nociception becomes a problem in diabetes and the mechanisms that are involved are unknown. Based on the preliminary data, the hypothesis was that glutamate pathways are likely to be involved in diabetic neuropathy particularly neuropathic pain. Pathways were investigated to look for changes that might reflect …

Role Of Myd88 Protein In The Maintenance Of Immunological Self-Tolerance: Induction Of Autoimmunity By Salmonella Infection Consequent To Myd88 Deficiency, Jincy Merin Issac

Dissertations

Activation of the innate immune system is a prerequisite for the induction of adaptive immune responses to both infectious and non-infectious agents. Toll-like receptors (TLRs) are a family of proteins important for recognizing pathogen associated molecular patterns. MyD88 is an adaptor molecule whose function is critical in TLR signaling. MyD88-deficient (MyD88-/-) mice exhibit heightened susceptibility to infections, even by attenuated strains of Salmonella enterica serovar Typhimurium. Paradoxically, despite their hypersusceptibility, infected MyD88-/- mice produce elevated serum levels of anti-Salmonella antibodies regardless of the route of infection. This hypergammaglobulinemia was observed with both Th1-driven (IgG2c and IgG3) and Th2-driven (IgG1) antibody …

Effects Of The Endocannabinoid Anandamide On Excitability And Calcium Signaling In Rat Ventricular Myocytes, Lina Tareq Al-Kury

Dissertations

Endogenous cannabinoids (endocannabinoids) exert a wide range of biological effects. In addition to having their well-known neurobehavioral effects, a role for the major endocannabinoid anandamide (N-arachidonoyl ethanolamide; AEA), in the cardiovascular system in various pathological conditions has been reported. The aim of this thesis is to explore the effects of AEA on contractility, Ca2+ signaling, and action potential (AP) characteristics in rat ventricular myocytes. A video edge detection system was used to measure myocyte shortening. Intracellular Ca2+ was measured in cells loaded with the fluorescent indicator fura-2 AM. AEA (1 μM) caused a significant decrease in the amplitude of electrically-evoked …

A Sleep Apnea Program For Commercial Drivers, Gayla Ann Dace

Dissertations

Sleepy driving is a major contributing factor to the motor vehicle crash risk associated with commercial drivers (Pack et al., 2006). In commercial vehicles, approximately 31% to 41% of major crashes can be linked to sleepy driving (Gurubhagavatula et al., 2004). An average non-fatality crash involving a commercial motor vehicle costs about $75,637 while a fatality crash averages about $3.54 million (Gurubhagavatula et al., 2004). A contributing factor to sleepy driving is obstructive sleep apnea (Pack et al., 2006). The purposes of this study were to: (1) determine how many commercial motor vehicle drivers referred to a sleep center as …

Relationship Between Horizontal Violence Among Registered Nurses And Falls, Elizabeth Densford Rocha Phd

Dissertations

Background: Horizontal violence is a manifestation of oppressed group behavior leading to low self-esteem and feelings of worthlessness among nurses. Horizontal violence leads to the creation of a hostile, unsafe work environment preventing nurses from performing at their highest potentials. A hostile work environment leads to a culture of unsafe patient care which may result in increased harm to patients. An understanding of why horizontal violence occurs and the implications of this phenomenon are the first steps in addressing this destructive behavior as well as protecting patients from harm. Health care environments must support nurses to perform at their best …

Processing And Characterization Of Innovative Magnesium Alloys For Biodegradable Orthopaedic Implants, Christopher E. Smith

Dissertations

There is a need for innovation in medical implant devices through novel biomaterials that will improve the quality of life. The first step in the creation of a foundation of knowledge and technology to improve these implant devices is through the creation of new alloys with the capabilities of biodegradation and bioabsorption without a toxic effect that will pass through FDA regulatory procedures. In this study, unique heat treatment processing techniques coupled with innovation in elemental alloying produced distinctive magnesium (Mg) based alloy systems. The MgZnCa system was used as the underpinning system where four groups of novel alloys were …

Does Participation In A Multi-Modal Activity-Based Program Impacts On Functional Recovery, And Quality Of Life In Adults With Spinal Cord Injury?, Carolyn S. Gerber Phd, Msn, Rn

Dissertations

The purpose of this study was to explore the relationships between relevant personal factors, participation in a multi-modal activity-based training program, and the program's impact on an individual's level of functional recovery, and overall quality of life in adults with Spinal Cord Injury (SCI). A descriptive, correlational design was performed on a secondary analysis dataset to conduct this study. Inferential statistics were performed with mixed ANOVA's on measures of ASIA UEM and LEM scores, EuroQol, and SWLS to compare their means. The study proposed that participation in a multi-modal activity-based training program would be associated with greater functional recovery, less …

Relationship Between Participation In Nurse Externship Program And Rn Retention And Quality Care, Lourdes C. Salandanan Phd

Dissertations

Study Background. Nurse externship programs were initially developed by healthcare institutions as a recruitment tool for new nurses. Literature has demonstrated the positive outcomes of the program on the participants and healthcare institutions but during times of economic difficulties, health care institutions discontinue the program. The studies that demonstrate the value of the program are limited to the recruitment phase and the 2-year retention of the newly graduated nurses. There is a need to demonstrate the value of the program in terms quality of care and long term RN retention. Research Questions. The three research questions this study addressed include: …

Factors Affecting Health Promotion Lifestyle Behaviors Among Arab American Women, Kholoud Khalil Phd

Dissertations

Guided by Pender and colleagues' (2006) revised health promotion model (HPM), this descriptive correlational study was designed to explore the relationships between personal factors (comprised of sociodemographic factors, degree of acculturation, and perceived stress), perceived health self-efficacy, perceived social support, and health promotion lifestyle behaviors (HPLBs) among a group of Arab American women (AAW) living in Southern California. A second purpose was to explore the psychometric properties of the translated version of the perceived health competence scale (PHCS). A convenience sample of 267 AAW were administered a paper copy of a self-reported survey. Four of the study's five standardized measures …

Shape Validated Secondary Structures Of Mason-Pfizer Monkey Virus (Mpmv) And Mouse Mammary Tumor Virus (Mmtv) Packaging Signal Rnas Reveal Pal Helix Loops Functioning As Dimerization Initiation Sites (Dis) Controlling Their Genomic Rna (Grna) Packaging, Suriya Jahan Aktar

Dissertations

The “diploid” genome of retroviruses consists of two strands of RNA that are non-covalently linked as a “dimer” at their 5’ ends. The ubiquitous presence of a dimeric genome among retroviruses suggests that dimerization plays a crucial role in gRNA packaging during viral life-cycle. For almost all retroviruses, determinants of gRNA dimerization and packaging, which are for the most part physically and genetically indistinguishable, reside at the 5’ end of the gRNAs and have been shown to assume higher order structures. Employing a combination of genetic and structural prediction approaches, we have earlier shown that Mason-Pfizer monkey virus (MPMV) and …

A Metaevaluation Of Evaluations Of Health Care Programs That Employ The Chronic Care Model, Jan Fields

Dissertations

Background: The purpose of this dissertation is to explore the use of metaevaluation to evaluate the quality of healthcare studies conducted on programs that employ the Chronic Care Model (CCM) to provide chronic illness care. In this study, healthcare studies of CCM programs are regarded as program evaluations. Method: Using a non-experimental cross-sectional design, 28 healthcare studies of CCM programs were evaluated using the accuracy standards portion of the Program Evaluations Metaevaluation Checklist (Stufflebeam, 2011). The results of the metaevaluations were analyzed and compared to the HEAL grade of the same healthcare studies as determined by the Hierarchy of Evidence …

Gdnf Content And Nmj Plasticity In Slow And Fast Twitch Myofibers Follows Recruitment In Exercise, Amy Morrison Gyorkos

Dissertations

Glial cell-line derived neurotrophic factor (GDNF) supports and maintains the neuromuscular system during development and through adulthood by promoting neuroplasticity. GDNF may play a role in delaying the onset of aging and help compress morbidity by preventing motor unit degeneration. Exercise has been shown to alter GDNF expression differently in slow and fast twitch myofibers. The aim of this dissertation project is to determine if different intensities of exercise can promote changes in GDNF expression and neuromuscular junction (NMJ) morphology in slow and fast twitch muscle fibers. Skeletal muscle fibers were analyzed from adult Sprague Dawley rats aged 4 weeks …

Impulsive Choice In Unmedicated And Medicated Children Diagnosed With Adhd: Examining The Variables Of Reward Type And Adhd Subtype, Nicole Henriksen

Dissertations

Developmentally inappropriate and impairing impulsive behaviors are often seen in attention-deficit/hyperactivity disorder (ADHD). One method for objectively assessing impulsivity is the Choice-Delay Task (C-DT) which presents repeated opportunities to choose between a smaller, sooner (SS) or larger, later (LL) reward. A preference for the SS reward that results in less total reward is considered impulsive. Many studies have found that participants diagnosed with ADHD choose the SS reward more than typical controls. However, less is known about the effects of different types of rewards, or the comparative performance of certain subgroups, such as children diagnosed with ADHD Predominantly Inattentive Type …

The Intersection Of Depression, Partner Violence And Poverty During The Perinatal Period, Catherine L. Kothari

Dissertations

Problem: Despite the wealth of research documenting the individual links between maternal depression, partner violence, and poverty, important gaps remain regarding their combined interactions, and their variation related to perinatal timing (pregnancy and postpartum). The current dissertation examined the interplay of these phenomena across perinatality.

Methods: This dissertation utilized secondary analysis of telephone survey data from a representative sample of women recruited during their postpartum hospital stay and interviewed four times over the subsequent 18 months. Linear regression was used for predictive modeling of fixed effects, and generalized estimating equation regression was used for multivariate analysis of temporal trends.

Findings: …

Numerical And Experimental Investigation Of Orthopaedic Fracture Fixation, Bipinchandra Patel

Dissertations

Poor bone fracture fixation leads to malunion, delayed union, non-union, or infection. These malunited fractures affect a bone’s ability to carry loads. Patient outcomes regarding fixation quality can be affected by the healing environment and human factors such as bone quality and surgeons’ perception. Furthermore, the stiffness and strength of the screw-plate construct affect the healing environment. Therefore, this dissertation investigates the stiffness and strength of the non-locking (conventional) and locking (fixed angle) type screw-plate constructs and the factors that contribute to them, such as screw-plate interface, screw design, bone density, cortical bone thickness and load orientation. Additionally, the surgeon’s …

Determinants Of Physical Activity In Arab American Children, Wearn Alkhatib Phd

Dissertations

Physical activity is an integral part of preventing and managing childhood and adolescent obesity. Lack of regular physical activity has negative impact on physical and psychosocial health. Arab Americans (AAs), one of the most rapidly growing minorities in United States, tend to have a high prevalence of obesity and low participation in physical activity. The purpose of this study was to describe determinants of physical activity, including self-efficacy, social support, physical environment, and selected demographics among AA children in Southern California. A descriptive correlational study using a cross sectional design was conducted. Self-administered questionnaires were completed by children (N=206) recruited …

Correlates Of Body Image Of Undergraduate Females Attending Andrews University, Jennifer L. Dabros

Dissertations

Problem: Literature on the relationship between ethnic identity and body image has been scarce, focusing almost entirely on the Asian and/or Hispanic population. The purpose of this study is to examine the influence that ethnic identity has on the body image of undergraduate females.

Method: In the present study, I explored the extent to which body image is related to ethnicity in a diverse sample of 345 undergraduate females (43.5% Caucasian American, 17.4% African American, 9.3% West Indian/Caribbean, 14.8% Hispanic American, 12.5%, Asian American, & 2.6% Multi-ethnic) from a Seventh-day Adventist university. Possible correlates of body dissatisfaction such as ethnic …

Factors That Relate To Registered Nurses' Readiness For Interprofessional Learning In The Context Of Continuing Professional Development, Collette Williams

Dissertations

Today’s health-care professionals practice in a highly technological, multidisciplinary environment. In order to provide safe, effective, and high-quality patient care, collaboration is required among all professionals. Traditionally each profession has operated independently in regard to continued professional development. The purpose of this study was to assess practicing registered nurses’ readiness toward interprofessional learning in order to align learning with current practice.

Method. An ex post facto study design was used to gather data to examine if there is a relationship between variables of demographics and readiness for interprofessional learning. The Readiness for Interprofessional Learning Scale (RIPLS) assesses the readiness for …

Collaborative Leadership Roles In The Implementation Of Adventist Health Lifestyle: A Case Study Of The Chinese Union Mission, James Wu

Dissertations

Problem

Little is known about the roles of the institutional leader’s role in the collaborative implementation of the Adventist health lifestyle programs of the Chinese Union Mission of the Seventh-day Adventist Church in Hong Kong and Taiwan. Such an understanding would provide clues regarding how collaborative leadership and the implementation of Adventist lifestyle programs meet the challenge of non-communicable diseases. According to the World Health Organization report, about 36 million people died in 2008 of non-communicable diseases, and the trend continues upward. Evidence-based research, such as the China Study and the Adventist Health Studies, provides a strong support for the …

Regulation And Targeting Of Fyn In Human Cutaneous Squamous Cell Carcinoma, Sarah Fenton

Dissertations

Fyn, a member of the Src family kinases, is an oncogene in murine epidermis and is associated with cell-cell adhesion turnover and migration. Introduction of active H-Ras(G12V) into the HaCaT human keratinocyte cell line resulted in upregulation of FYN mRNA (200-fold) and protein, but did not increase the expression of other SFKs. We identified two nucleotides 74 bases upstream of the human FYN gene transcription start site as necessary for FYN upregulation in HaCaT-Ras cells. Further studies identified Lef-1 as the transcription factor most likely binding to this site and mediating FYN upregulation.

Transduction of active Ras or Fyn was …

The Symptom Experience Of Patients Receiving Epidermal Growth Factor Receptor Inhibitors, Josephine Ann Howard-Ruben

Dissertations

This study explored the symptom experience of patients receiving epidermal growth factor receptor inhibitors (EGFRIs) for breast, colon, head and neck, and colon cancer. EGFRIs are targeted therapies used at various points along the treatment continuum for these solid tumors, and may be first, second or third-line agents which can be used as single agents or in combination with other therapies. The most common side effect of these agents include dermatologic effects, such as rashes, hair, and nail changes, but they can also contribute to other side effects such as fatigue, anxiety and diarrhea. Most previous work has addressed the …

The Impact Of Insulin Management On Quality Of Life In Type 2 Diabetes, Sandra Ellen Mccormick

Dissertations

Complications of type 2 diabetes (T2DM) are severe but can be minimized through excellent glycemic control, optimally achieved by using intensive, or basal-bolus, insulin management. The quality of life (QOL) effects of basal-bolus insulin management are not fully known. This cross-sectional, observational study was based on the Revised Wilson and Cleary Model for Health Related Quality of Life, which measures five QOL domains (biological function, symptoms, functional status, general health perceptions, and overall QOL). The study aims were to describe, compare, and predict QOL in persons with T2DM based on type of insulin management (oral meds only, basal insulin only, …

Peripubertal Binge Ethanol, Age And Sex Modulate Microrna Expression In The Ventral And Dorsal Hippocampus Of The Adolescent Rat, Sarah Arianne Prins

Dissertations

Adolescent binge ethanol (EtOH) abuse induces long-term changes in gene expression, resulting in an increased risk for the development of adult mood disorders. microRNAs (microRNAs) are small, noncoding RNAs that regulate gene expression by translational repression. microRNA altered in response to EtOH and puberty in the developing brain. The biogenesis of mature 22-24 nucleotide (nt), single-stranded microRNAs involves Drosha and Dicer enzymatic processing of microRNA precursors. A mature microRNA imperfectly base pairs with messenger RNA (mRNA) target genes,which leads to mRNA cleavage or translational repression. Our lab has found that repeated binge EtOH exposure alters gene expression in the hypothalamus …

Psychometric Evaluation Of The Neonatal Pain, Agitation, And Sedation Scale (N-Pass) Tool In Infants And Children Age One To Thirty-Six Months In The Post-Anesthesia Care Unit, Patricia A. Hummel

Dissertations

The purpose of this study was to investigate the Neonatal Pain, Agitation, and Sedation Scale (N-PASS) tool for evidence of validity and reliability in infants and children aged one to thirty-six months in the Post-Anesthesia Care Unit (PACU). This study design was a prospective, non-experimental psychometric evaluation of the N-PASS tool.

The research was conducted at a Midwestern Medical Center. The sample analyzed comprised forty subjects aged one to thirty-six months.

Data collection involved the evaluation of participants every five minutes, utilizing the N-PASS sedation subscale along with the University of Michigan Sedation Scale (UMSS) and the N-PASS pain/agitation subscale …